System and method of providing dynamic and customizable medical examination forms

ABSTRACT

A system and method of providing dynamic and customizable medical forms is disclosed. In certain specific embodiments, these dynamic and customizable medical forms may be automatically presented to users based on a predefined series of rules which allow multiple users having different roles in the clinical process to collaborate and contribute to a medical examination report, while at the same time maintaining an independent record of what was contributed and by whom it was contributed.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.13/768,765, filed Feb. 15, 2013, which is a continuation of U.S. patentapplication Ser. No. 12/622,404, filed Nov. 19, 2009, which claims thebenefit of U.S. Provisional Patent Application No. 61/116,191, filed onNov. 19, 2008, the entire disclosure of which is incorporated byreference herein.

BACKGROUND

Field of the Invention

This application relates to the dynamic creation and customization ofcomputer-based electronic forms which may be used for inputting,collecting, accessing, and presenting medical information.

Description of the Related Art

Existing medical examination forms do not optimally serve the needs ofvarious users who frequently must collaborate to collect relevantclinical and demographic data, and ultimately compile this data forvarious purposes, including creation of medical reports, retrospectivelyanalyzing the collected data, and uploading data to other repositories(such as clinical data repositories).

SUMMARY

The system, method, and devices described herein each have severalaspects, no single one of which is solely responsible for its desirableattributes. Without limiting the scope of this disclosure, severalnon-limiting features will now be discussed briefly.

In a first embodiment, a method of providing an examination form isprovided. The method includes storing a plurality of examination formtemplates. The examination form templates each comprise a plurality ofdata fields configured to receive data related to a medical examination.At least one data field is associated with a link to an external datasource. The method further includes receiving a selection of one of theplurality of examination form templates and storing examination formtemplate presentation rules. An instance of an examination form isgenerated based on the selected examination form template for display toa user. The generated instance is based at least in part on the templatepresentation rules. Data is automatically received into the examinationform instance from one or more data sources based on the link, and userinput is received which includes data which modifies information in theexamination form. The modified examination form instance is stored in amemory, and information is exported from the examination form instanceto one or more destinations.

In another embodiment, a method of producing a medical report using anelectronically generated medical examination form is provided. Themethod includes receiving a request from a user for an examination form,the request comprising data indicative of selection criteria. The methodfurther includes identifying one or more medical examination forms froma collection of medical examination forms based at least in part on thedata indicative of the selection criteria. One or more of the medicalexamination forms are selected from the identified examinations forms,and an instance of the selected form is generated for display to theuser. The method further includes receiving a plurality of data inputsinto the medical examination form and automatically exporting theplurality of the data inputs.

In another embodiment, a method of providing an examination form forcollaboration between multiple users within a medical organization isprovided. The method includes receiving a selection of an examinationform template comprising a plurality of data fields configured toreceive data related to a medical examination and to export datareceived into the form. The method further includes receivingindications of links between respective data fields of the examinationform and respective data sources, the links comprising one or moreimport links and one or more export links. Data is automaticallyreceived into the examination form from one or more data sources basedon the import links, and a first view of the examination form isgenerated for display to a first user having a first role. The firstview is configured to receive data in a first subset of the data fields.The method further comprises receiving data input into at least some ofthe first subset of data fields of the first view of the examinationform, and generating a second different view of the examination form fordisplay to a second user having a second role, wherein the second viewis configured to receive data in a second subset of the data fields,wherein the first subset of data fields includes at least one data fieldnot included in the second subset of data fields. Data input into atleast some of the second subset of data fields of the second view of theexamination form is received. The method further includes determiningone or more data fields associated with export links; and exporting datafrom the determined one or more fields to one or more locations.

In still another embodiment, a method of providing dynamic medicalexamination forms to provide efficient comparison of medical examinationresults is provided. The method includes storing a first medicalexamination form in a memory, the first medical examination formcomprising one or more data fields having data associated with firstimaging data generated for a first medical examination. The methodfurther includes generating a second medical examination form based onthe first medical form, the second medical form comprising the datafields and data from the first medical form, and further comprisingadditional data fields configured to receive data associated with secondimaging data generated for a second medical examination. The firstimaging data, the second imaging data, and the second medical form areconcurrently displayed, and data associated with the second imaging datainto the additional data fields is then received.

In still another embodiment, a system for creating dynamic medicalexamination forms is provided. The system comprises a first moduleconfigured to store a first medical examination form in a memory, thefirst medical examination form comprising one or more data fields havingdata associated with first imaging data generated for a first medicalexamination. The system further includes a second module configured togenerate a second medical examination form based on the first medicalform, the second medical form comprising the data fields and data fromthe first medical form, and further comprising additional data fieldsconfigured to receive data associated with second imaging data generatedfor a second medical examination. A third module is configured todisplay the first imaging data, the second imaging data, and the secondmedical form at the same time, and a fourth module is configured toreceive data associated with the second imaging data into the additionaldata fields.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a system diagram which shows one embodiment of a system forcreating dynamic and customizable medical examination forms.

FIG. 2 is a high level flowchart of one example process for using adynamic medical examination form system such as the one shown in FIG. 1.

FIG. 3 is a more detailed flowchart illustrating one embodiment of adynamic medical examination form template creation process.

FIG. 4 is a more detailed flowchart illustrating one embodiment of adynamic medical examination form template selection process.

FIG. 5 is a more detailed flowchart illustrating one embodiment of adynamic medical examination form template instance creation process.

FIG. 6 is a more detailed flowchart illustrating one embodiment of aprocess for using a selected instance of a dynamic medical examinationform.

FIG. 7 is more detailed flowchart illustrating one embodiment of aprocess for exporting information collected in a dynamic medicalexamination form as shown in FIG. 2.

FIGS. 8A-8D are examples of graphical user interfaces which may beprovided with dynamic medical examination form software according to oneor more embodiments.

FIG. 8E is an example of a graphical user interface of a reportgenerated through the use of dynamic medical examination form software

FIG. 9 is a sample graphical user interface illustrating how dynamicmedical examination forms may be used in conjunction with externalsoftware in accordance with one or more embodiments.

FIGS. 10A, 10B (comprised of 10B-1 and 10B-2), 10C, 10D (comprised of10D-1 and 10D-2), 10E, 10F, and 10G (comprised of 10G-1 and 10G-2) areexamples of additional embodiments of graphical user interfaces used forcreating and using dynamic medical examination forms and theirassociated reports.

DETAILED DESCRIPTION

One or more embodiments disclosed herein provide a system and method forproviding dynamic and customizable medical examination forms. In certainspecific embodiments, these dynamic and customizable medical forms maybe automatically presented to users based on a predefined series ofrules which allow multiple users having different roles in the clinicalprocess to collaborate and contribute to a medical examination report,while at the same time maintaining an independent record of what wascontributed and by whom it was contributed. For example, in certainembodiments, medical examination forms may be completed by anon-physician user such as a technologist. Some of that data may beautomatically imported into a physician's reading report. However, inorder to ensure reliability of data and to enable effective qualitycontrol measures, the examination forms may be associated with datawhich is indicative of who completed the form, when it was completed,who modified the form, and the like. Moreover, the medical examinationforms disclosed herein may be subject to file protections whichautomatically (or manually) determines who can view, create, modify,delete, name, and/or link the medical examination forms.

The medical examination forms may contain text, graphics, and/orpictures. The medical examination forms may be used by various differentparties having various different roles in an organization. For example,in the context of a medical practice, the medical examination forms maybe used by a scheduler, a technician, a physician, or some otherauthorized user. Medical examination forms described herein may becreated and/or used for various medical conditions, examination types,and the like. Moreover, certain medical examinations may involve the useof multiple examination forms.

The choice of which medical examination form to use for a particularsituation may be manual or automatic and may be based on many differentparameters. For a particular medical examination, there may be none,one, or more than one examination forms created. The choice of a medicalexamination form may be based on one or more of medical imagingmodality, examination type, clinical history of the patient, demographicinformation about the patient, prior examinations, facility at which anexam is conducted, the type of scanner used for an imaging scan, thetype of insurance a patient holds, the location of the patient, whetherthe patient inpatient or outpatient, indications for the examination,referring physician, referring physician attributes (such as specialty)and/or the requested reading physician (or reading physicianattributes).

The medical examination forms may be configured to provide informationfields that are pre-populated with designated information from variousexternal data sources, including but not limited to PACS, EMR, HIS,clinical laboratory systems, prior medical reports, and the like. Theexternal data sources may include systems provided by the same vendor asthe examination forms, and the external data sources may also includesystems provided by other vendors. Accordingly, an external data sourcemay be any source of data or information that exists outside of theexamination form itself. The dynamic medical examination forms mayinclude fields that may receive updated data (e.g., in a subsequentpatient examinations) regarding detected anomalies found in priorpatient examinations. In some embodiments, the examination formsthemselves may be updated during follow up examinations to includeadditional detected anomalies which were undetected during priorexaminations. The updates to the examinations forms may include theaddition of new fields or new links to external data made relevant bythe additional detected anomalies. When an examination form has beencompleted, it may be exported to various different other systems. Thesesystems may be systems provided by the same vendor as the examinationforms. These other systems may also include systems provided by othervendors. For example, the medical examination forms and or variouscontents of the forms may be exported into a word processing document,an HL7 document, a PDF file, a database, an electronic medical record, aPACS system, or even a web-based registry or credentialing organization.Depending on the specific embodiment, the medical examination forms mayor may not adhere to cross-enterprise document sharing (XDS), one of IHEtechnical frameworks, which describes how to apply standards intoinformation systems for the sharing of medical documents amonghospitals. Similarly they may or may not include the Clinical DocumentArchitecture (CDA) schema based on HL7.

FIG. 1 is a system diagram which shows the various components of asystem 100 for creating dynamic and customizable medical examinationforms. As shown the system 100 may include a dynamic examination formcomputing device 150. The dynamic examination form computing device 150may take various forms. In one embodiment, the dynamic examination formcomputing device 150 may be a computer workstation having dynamicexamination form software modules 151. The dynamic examination formsoftware modules 151 will be described in detail below. The computerworkstation may be a standard personal computer running off-the-shelfoperating systems 159 such as a Windows, Linux, or MacOS. The computerworkstation 150 may also run a more specialized operating system whichmay be designed for the specific tasks performed by the computing device150. In addition to taking the form of a desktop computer orworkstation, the computing device 150 may be a laptop computer, a tabletcomputer, a notebook computer, a netbook computer, a handheld computingdevice, or some other type of computing device.

The dynamic examination computing device 150 may include one or morecomputing processors 156. The computer processors 156 may includecentral processing units (CPUs), and may further include dedicatedprocessors such as graphics processor chips, and the like. Theprocessors generally are used to execute computer instructions based onthe dynamic examination form modules 151 to cause the computing deviceto perform operations as specified by the modules 151. The modules 151may include, by way of example, components, such as software components,object-oriented software components, class components and taskcomponents, processes, functions, attributes, procedures, subroutines,segments of program code, drivers, firmware, microcode, circuitry, data,databases, data structures, tables, arrays, and variables. For example,modules may include software code written in a programming language,such as, for example, Java, Javascript, ActionScript, Visual Basic, Lua,C, C++, or C#. While “modules” are generally discussed herein withreference to software, any modules may alternatively be represented inhardware or firmware. Generally, the modules described herein refer tological modules that may be combined with other modules or divided intosub-modules despite their physical organization or storage.

The dynamic examination computing device 150 may also include memory157. The memory 157 may include volatile data storage such as RAM,SDRAM. The memory 157 may also include more permanent forms of storagesuch as a hard disk drive, a flash disk, a solid state drive, or someother type of non-volatile storage.

Also included in the dynamic examination computing device 150 may bevarious input and output devices 158 which receive information inputsand provide information from users. The input/output devices 158 mayinclude a video display, such as one or more high-resolution computermonitors. The input/output devices 158 may also include a keyboard,mouse, touchscreen, microphone, voice command input system, and/ortablet, for example, that are configured to allow the user to provideinput to the computing device 150.

The dynamic examination form computing device 150 may communicate and/orinterface with other systems and/or devices. In one or more embodiments,the computer device 150 may be connected to a computer network 205. Thecomputer network 205 may take various forms. It may be a wired networkor a wireless network, or it may be some combination of both. Thecomputer network 205 may be a single computer network, or it may be acombination or collection of different networks and network protocols.For example, the computer network 205 may include one or more local areanetwork (LAN), wide area network (WAN), personal area network (PAN),and/or the Internet. Various devices and subsystems may be connected tothe network 205. For example, one or more MRI scanners 120 may beconnected to the network. The MRI scanner 120 may be used to acquire MRIimages from patients, and may share the acquired images with otherdevices on the network 205. The network 205 may also include one or moreCT scanners 122. The CT scanners 122 may also be used to acquire imagesand, like the MRI scanner device, may then store those images and/orshare those images with other devices via the network 205. Any otherscanner or device capable of inputting images could be included,including ultrasound, angiography, nuclear medicine, radiography,endoscopy, pathology, dermatology, etc.

Also connected to the network may be a picture archiving andcommunications system (PACS) database server 130. The PACS databaseserver 130, along with PACS image server 136 (used to serve images inresponse to client requests) and PACS workstation 138 (used to provide aclient interface to the PACS server components), form part of a PACSsystem. In some embodiments, the PACS database server 130 may include aPACS database which stores image data.

In the embodiment shown in FIG. 1, the PACS database server 130 alsoincludes a dynamic examination form template database 132. In otherembodiments the dynamic examination form template database 132 may bepresent in a different server, for example in a server accessible on thelocal LAN or in a server that is located remotely and accessible via theInternet. The dynamic examination form template database 132 storesexamination form templates that have been created by the dynamicexamination form software 151. These stored templates may be used tocreate new dynamic examinations forms as is discussed below.

The PACS system is typically used for the storage, retrieval,distribution and presentation of images (such as those created and/orgenerated by the MRI scanner 120 and CT Scanner 122). The medical imagesmay be stored in an independent format, an open source format, or someother proprietary format. The most common format for image storage inthe PACS system is the Digital Imaging and Communications in Medicine(DICOM) format. The stored images may be transmitted digitally via thePACS system, often reducing or eliminating the need for manuallycreating, filing, or transporting film jackets.

The network 205 may also be connected to a radiology information system140. The radiology information system 140 is typically a computerizeddatabase system that is used by radiology departments to store,manipulate and distribute patient radiological data and imagery. Alsoattached to the network 205 may be an electronic medical record (EMR)system 142. The EMR system 142 may be configured to store and makeaccessible to a plurality of medical practitioners computerized medicalrecords. Also attached to the network 205 may be a clinical laboratoryinformation system 144. The clinical laboratory information system 144is typically a software system which stores information created orgenerated by clinical laboratory process. In other embodiments, othercomputing devices that store, provide, acquire, and/or otherwisemanipulate medical data may also be coupled to the network 205 and maybe in communication with one or more of the devices illustrated in FIG.1, such as with the examination form computing device 150.

As will be discussed in detail below, the dynamic medical examinationform computing device 150 may be configured to interface with variousnetworked computing devices in order to provide efficient and usefulreview of medical examination data that is stored among the varioussystems present in the network.

According to certain embodiments, dynamic medical examination forms maybe provided which allow multiple users in the healthcare environment tocollaborate to contribute data and information to a medical report insuch a way that efficiencies are realized by assigning specific and/orlimited tasks to each party involved in the medical documentationprocess. These efficiencies may be gained by providing a single dynamicmedical examination form which (1) automatically receives data alreadyknown by some other entity in the system to avoid repetitious dataentry; (2) automatically exports data inputted into the examination formto the external systems which require the data; and/or (3) providesappropriate access to each party involved in the creation of the medicalexamination form.

FIG. 1B is a block diagram illustrating a high-level view of the inputsand outputs from a medical examination form according to one or moreembodiments. A medical examination form 170 may be connected to variousdata sources 180. The data sources 180 may be various different systemson the network 205, such as those described above in connection withFIG. 1A. According to certain embodiments, the dynamic medicalexamination form may be defined to automatically receive informationfrom these data sources 180 based on presentation rules defined for thecreation of the forms. For example, when a medical examination form isgenerated for a specific patient, a general presentation rule mayindicate that the patient's demographic information be automaticallybrought into the medical examination form from an external patientdatabase, such as the EMR 142. If the medical examination form is to beused for an MRI examination, for example, the MRI imaging data may beimported automatically into the form based on presentation rules forexamination forms used in conjunction with MRI examinations.

For a given patient examination, many different types of data may begenerated which may need to be sent to various different types ofsystems. For example, a report may need to be created by the physicianspecialist interpreting and reading a medical imaging examination sothat the referring physician may be apprised of the examination outcome.Alternatively, or in addition, a report may also need to be createdwhich allows the reading physician to easily find the data crucial tosuch a review. Additional data captured during the examination process(and in the medical examination form) may also need to be exported to anexternal system used for quality assurance, tracking of specificcritical results, credentialing, data mining, inventory control, ormedical billing system. These and other different systems and datarepositories may receive some specified portion of the data entered intothe examination form. Similarly, data repositories may receive onlythose data portions that are relevant to the respective repository,which may increase the efficiency and accuracy of the data repositoriesin properly categorizing the received data, and may reduce bandwidthneeds since not all of the data is transmitted to all data repositories.In fact, each repository and/or group of repositories may be associatedwith delivery rules that indicate which portions of the data istransmitted to the repository. In the example shown in FIG. 1B, datareceived in the examination form 170 is sent to various datadestinations 190. These data destinations may include a reading report190, a billing system 192, a data repository 194, or some other datadestination 196.

Because the different users and participants in the medicaldocumentation process often play radically different roles in theinformation gathering and evaluation process, the medical examinationform 170 may be configured to be presented in different ways todifferent users. In some embodiments, how a medical examination form 170appears to a user may be predefined based on a series of rules thattakes into account various attributes of the user, patient, exam,modality, location, etc. For example, the rules may be defined so thataspects of an examination form presented to a user may be dependent onthe user's role within an organization. A technologist may see certainspecific portions of the examination form, while a doctor may bepresented with other portions of the form because each is responsiblefor entering and reviewing different data in the form. Each of thedifferent presentations of a particular examination are referred toherein as “views” of the medical examination form. Thus, an examinationform may have multiple views each based on a similar template, but eachpotentially importing different data, displaying different data, and/orexporting different data. In the example provided in FIG. 1B, variousviews are defined for the medical examination form 170: a physician view172, a technologist view 174, a nurse view 176, and a billing view 178.While specific views based on personnel roles are shown in FIG. 1B, itis to be appreciated that different views may be defined based on almostany attribute. For example, a doctor may be presented with one view ofthe form before the actual associated medical examination takes place,while he may be presented with an entirely different view after theexamination has taken place and a technologist has entered examinationdata.

In some embodiments, the different views may be used to protect orensure the reliability of data entered into the medical examinationform. For example, fields in a medical examination form may bedesignated as required data entry fields which prevent a user fromsaving an updated form unless they have entered appropriate data in therequired data entry fields. Other fields may be protected from access ormodification so that unauthorized users do not inadvertently (or evenintentionally) change data in an examination form.

Alternatively, a single examination form may be presented to a single orvarious different intended users. As yet another alternative, a singleexamination form may be presented to various different users withdifferent accessible or editable fields depending on the user, or otherconfigurable conditions. Therefore, one can define a “view of anexamination form” as an instance of an examination form created from anexamination form template. One of more such views of an examination formcan be presented during the life cycle of an examination, and inaddition, there may be multiple different examination forms for anyparticular examination.

FIG. 2 is a high level flowchart of a process by which dynamic medicalexamination forms may be created according to one or more embodiments.The process shown in FIG. 2 is typically performed by the dynamicmedical examination forms software 151, executing on the examinationforms computing device 150 (or other computing device). However, one ofskill in the art will readily appreciate that the process may beperformed by more software distributed across a plurality of systems. Inone embodiment, a software application that is installed on thecomputing system 150 may generate various user interfaces forinterfacing with an operator (e.g., a physician or radiologist), and mayinclude multiple software modules that interface with one another, suchas a template creation module, template selection module, examinationform creation module, and/or examination form export module, which areeach described in further detail below. As used herein, the term“medical examination forms software” refers to a software applicationthat includes one or more of the modules discussed herein, and which maybe executed on a computing device such as the computing device 150, PACSworkstation 138, and/or any number of other computing devices. Dependingon the embodiment, the method of FIG. 2 may include fewer or additionalblocks and/or may be performed in a different order than is illustrated.For example, in certain embodiments, one or more of the blocks shown inFIG. 2 may not be performed.

Software code for performing the methods described herein, including themethods of FIGS. 2-7, may be executed by examination form computingdevice 150, the PACS workstation 138, the EMR system 142, the radiologyinformation system 140, and/or any other suitably configured computingdevice. The software code may be embodied in a computer readable mediumconfigured for reading by a computing device in order to store thesoftware code in one or more memories of the computing device forexecution.

The process begins at block 210, where a template creation module isused to dynamically create an examination form template which may bestored in the examination form template database 132. Additional detailsof the template creation process are provided below in connection withFIG. 3.

The process may then move to block 215, where a user of the medicalexamination forms software 151 may use the template selection module inorder to select a stored template from the examination form templatedatabase 132. As will be described in more detail below in connectionwith FIG. 4, the template selection module allows a user to find whichexisting examination form template best suits the examination for whichthey intend to use the form. In some embodiments, the template may bechosen manually by the user.

Alternatively, an automated process may be used to select a dynamicexamination form template based on specified criteria. These criteriamay include the examination type that will be conducted, medical imagingmodality, attributes of the specific type or model of scanner utilized,patient history, prior examinations, clinical information, the clinicalindication for the exam, the facility at which the exam is conducted,insurance information, attributes related to people and entities thatwill receive the results of the examination such as tumor measurementsrequired by clinical studies, attributes of referring/orderingphysicians (including general attributes such as specialty as well aspreferences related to individual physicians), and attributes related tothe user for the form (including general attributes such as specialty oruse role, and well as preferences of the specific users).

Once the appropriate template has been selected, automatically, manuallyor by some combination, an instance of a dynamic medical examinationform may then be generated at block 220 based on the selected template.Thus, the instance created from the template is a first view of theform. As discussed above, multiple other views of the form, eachpotentially importing data from different data sources and/or outputtingdata to different data destinations, may or may not be implemented. Insome embodiments, the medical examination forms software includes aninstance creation module that generates the examination form instancewhich may be used to capture data relating to a specific medicalexamination of a patient. An exemplary process for generating theexamination form instance is discussed in additional detail below inconnection with FIG. 5.

Once an instance of the examination form has been created, the processthen moves to block 225, where the examination form may be accessed andfilled out by an appropriate user. As will be discussed below inconnection with FIG. 6, this process may involve manually enteringinformation on the examination form instance, and may additionallyinvolve auto-populating the form with information related to the patientfrom other devices or systems on the network 205. Once the examinationform has been completed, and data has been received or entered into theform, the process then moves to block 230, where the data collected inthe view of the examination form may be exported to other systems on thenetwork 205 for archiving or storage.

As discussed above, in certain embodiments, a healthcare professionalusing the dynamic examination form software 151 may use the software todynamically create medical examination form templates. Views ofelectronic examination forms that are used in the course of patientmedical examinations may be created using the templates that are createdby the examination form template creation module. FIG. 3 is a moredetailed flowchart of an exemplary process by which a dynamic medicalexamination form template may be created. Depending on the embodiment,the method of FIG. 3 may include fewer or additional blocks and/or maybe performed in a different order than is illustrated.

The process begins at block 310, where the template creation module isinitialized, such as by the user making an appropriate menu selection ina user interface displayed on the computing device 150. The process thenmoves to decision block 315, where the user is offered a choice as towhether to create an entirely new template, or to create the templateout of an already existing examination form template.

If at decision block 315, the user chooses not to create a new template,and instead modify an existing template, the process moves to block 320,where the user chooses an existing template. The existing templates maybe presented to the user as a menu choice in which the templatedescription is displayed to the user. In some embodiments, the user maybe permitted to display a preview of the content of the templatespresented in the menu. Allowing this type of preview helps to ensure amore accurate template choice by the user. Once the user has selectedtheir existing template of choice, the process then moves to block 322,where the selected template is retrieved from the dynamic examinationform template database 132, which may be on the PACS database server130. In other embodiments, examination form templates may be storedlocal to the computing device (e.g., on a hard drive or optical drive,or available via a LAN) and selectable in block 320. After the selectedtemplate has been retrieved, the process then moves to block 324, wherethe user modifies the selected template according to the current patientexamination needs. After the user has modified the selected template,the process then moves to block 340, where examination form export rulesare modified. In some embodiments, the existing template selected by theuser may already include export rules. In these instances, the user mayadopt the existing export rules. Alternatively, the user may modify thealready existing export rules to fit the needs of the modified template.

Returning to decision block 315, if the user chooses to create anentirely new dynamic examination form template, the process moves toblock 330, where the user constructs an entirely new template. Onespecific embodiment describing how the user may construct a new templateis discussed below in connection with FIG. 8A. Once the new template hasbeen created by the user, the process then moves to block 340 (discussedabove), where export rules may be created for the template. Once theexport rules have been created, the process then moves to block 345. Atblock 345, the user may indicate that the template is finished, and thetemplate is stored in the examination form template database 132 (orother database, either local or remote). Once the new template has beenstored in one or more databases, the template creation process ends atblock 350, and the system exits the examination form template creationmodule.

As discussed above in connection with FIG. 2, users of the dynamicmedical examination form software 151 may select an examination formtemplate that suits their needs, or the system may be configured toselect a template based on certain criteria. Turning now to FIG. 4, aflowchart provides one example of how a template stored in the templatedatabase 132 may be selected for use in a medical examination. In theexample shown in FIG. 4, based on information about the examination forwhich the template will be used, the system attempts to select theappropriate template for the user. If the appropriate template is notfound, the user may manually select a template. Depending on theembodiment, the method of FIG. 4 may include fewer or additional blocksand/or may be performed in a different order than is illustrated.

The process begins at block 410 where the template selection module isinitialized to receive input from a user. For example, a software modulemay be called in response to the user making a selection in theexamination form software 151 (e.g., via a user interface generated bythe software 151 and presented on a display device of the computingdevice 150) indicating a desire to create a new examination form basedon a template. Alternatively, this may occur automatically, for examplewhen a medical examination is performed by technologist or presented forinterpretation to radiologist or cardiologist on a PACS workstation. Theprocess next moves to block 415, where the template selection moduleretrieves examination features related to one or more of the examinationto be performed, the user, the location, etc., for which the templatewill be used The process next moves to block 420, where the retrievedexamination features are compared with examination templates stored inthe template database 132. Based on that comparison, the templateselection module makes an initial selection of the stored template thatbest fits the retrieved examination features at block 425 and presentsthat selection to the user.

The process next moves to decision block 430, where the templateselection module determines whether the user agrees with the automaticselection, such as by receiving an input from the user indicating such.If the user does not agree with the automatic selection, the processmoves to block 435, where the user manually selects a template fromwhich to create the new examination form and the process then moves toblock 450 and the template selection module exits. If, however, the userdoes agree with the automatic selection of a template from the database,the process moves directly to block 450 where the template selectionprocess ends. In one embodiment, the automatic template selectionprocess selects more than one possibly matching template and presentsthe templates to the user sequentially (e.g., in response to the userindicating that an earlier presented template is not desired) and/orconcurrently (e.g., thumbnails of multiple located templates may bedisplayed to the user).

As discussed above in connection with FIG. 2, after a template has beenselected for the dynamic medical examination form, an instance (e.g., afirst view) of an examination form may be created based on the selectedtemplate. FIG. 5 provides a more detailed view of one process ofinstantiating a dynamic examination form referenced at block 220 of FIG.2 above. Depending on the embodiment, the method of FIG. 5 may includefewer or additional blocks and/or may be performed in a different orderthan is illustrated.

The process begins at block 510, where the examination form instancecreation module is initiated. Next, the process moves to block 515,where the information from the template selected by the templateselection module (or manually by the user) is retrieved from thetemplate database 132. The process then moves to block 520, where aninstance of the retrieved examination template is created. Theinstantiation of the template provides a new examination form that maybe used in a patient examination. Once the examination form has beeninstantiated, the process then moves to block 525, where one or morefields in the examination form may be pre-populated. For example, thefields may be populated by retrieving field values, such as data fromthe database or DICOM data stored in the PACS system, for example. Insome embodiments fields in the examination form may be mapped tospecific data stored in these external systems, and the examination formmay be configured to automatically retrieve these values. Additionaldetails about the mapping process are discussed below in connection withFIGS. 8 and 9.

Once all of the pre-population data has been retrieved, the process nextmoves to block 530, where a view of the examination form is generatedfor display using the retrieved data. The view is displayed to the userso that it may be reviewed, modified, and/or updated based on theresults of a subsequent patient examination, for example. Once the viewof the examination form has been created and displayed to the user, theexamination form instantiation module terminates.

After completion of the process shown in FIG. 5, a view of the medicalexamination form has been created and it can be used for collecting datarelated to a patient medical examination. FIG. 6 is a detailed exampleof how a dynamic examination form may be used in accordance with one ormore embodiments. Depending on the embodiment, the method of FIG. 6 mayinclude fewer or additional blocks and/or may be performed in adifferent order than is illustrated.

The process begins at block 610, where the examination form utilizationmodule is initiated. Next, in block 615, the selected and instantiateddynamic medical examination form (e.g., the first view of theexamination form), including data that has been pre-populated into theform from one or more data sources, is displayed to the user. At block620, the user interacts with the view of the examination form to enterand/or modify the appropriate data. Use and operation of an exemplaryexamination form will be discussed in further detail below in connectionwith FIG. 9.

After the medical examination form has been completed, either manuallyby a user or automatically, the data entered into the view may then beexported to other systems. By way of example and not of limitation, thedata may be exported into a radiology report that may be used by theradiologist. The data may further be exported into an external database,for example, a backup database. Collected data may also be exported tothe various other systems on the network 205. These systems may includethe PACS, RIS, EMR system or some other clinical information system.

FIG. 7 is a flowchart providing one example of a process by whichinformation entered into the examination form (e.g., a particular viewof an examination form) may be exported to other devices. Depending onthe embodiment, the method of FIG. 7 may include fewer or additionalblocks and/or may be performed in a different order than is illustrated.

The method begins at block 710, where the examination form export moduleis initialized. The process then moves to block 715, where the exportmodule retrieves the examination form export rules from the examinationform template database 132 (or from another data source in otherembodiments). Next, at block 720, data from the examination form istranslated into the appropriate format for storage in the externalsystem (if necessary) based on examination export rules retrieved fromthe template database 132. Once the data has been translated, the datais exported from the examination form to the selected destination systemat block 730. When the data has finished exporting, the process ends atblock 750 with the export module exiting.

As discussed above with reference to FIGS. 3-6, a user may construct anew template, instantiate that constructed template, and then use theinstance of the template to collect and record data related to a patientexamination. FIGS. 8A-8E provide an illustration of certain aspects of agraphical user interface environment in which a user may perform theseprocesses according to one or more embodiments.

With specific reference to FIG. 8A, a graphical user interface generatedby a patient management software application, such as the examinationforms software 151 of FIG. 1, includes a tab which allows a user tocreate a new medical examination form using a base template stored inthe template database 132, or to create a medical examination form usingan already stored template, by modifying and updating the existingtemplate to suit their needs.

As discussed previously, medical examination form templates may becreated using the process described in FIG. 3. In some embodiments, thecreated examination form templates may be configured to interact with orlink to external data by default. For example, a template may beconfigured to map data items in the form template to text and/or imagedata in a medical data database such as the PACS database 131, forexample. The template creator may also designate sections or fields inthe template which may be automatically mapped into an external report,such as a reading physician's report that may be created based on thedata in the examination form. The template may also be configured toimport or pre-populate certain fields with data from external sources.In some embodiments, the examination forms may be uniquely named orassociated with a unique identifier, and may be further cross-linked toa specific examination type in order to allow the user to more easilylocate the appropriate examination form. By providing these identifyingcharacteristics about the examination form, the system may be configuredso that the examination form automatically appears for appropriate users(including, but not limited to, clerical staff, technologists, andreading physicians) when an examination type is selected. In additionalembodiments, the medical examination forms may be cross-linked to otheritems such as a particular facility, an insurance company or type,patient attributes such as age or sex, clinical indications, patienthistory, and/or some other data item. Based on this cross-linking,appropriate examination forms (one or more) may be presented to a userbased on the cross-linked items.

When an examination form is created, it may be configured to containmultiple components and graphical user interface elements, includingfree text, drop down menus, radio buttons, checkboxes, textboxes, and/ordata fields. As noted above, the creator of the medical examination formmay designate fields that can be automatically imported from variousdata sources, such as medical records and/or imaging databases. Thecreator may also designate examination form fields to be exported to adatabase or other repository.

By way of example and not of limitation, an examination form may bedefined which includes the following text and fields, where a field isindicated by brackets and surrounding text:

-   -   Referring Doctor Name: [refdoc]    -   Time of Exam: [exam time]

In this example, the fields [refdoc] and [exam time] may be mapped to beimported from one or more locations. Alternatively, these fields mayhave associated mappings which cause their data to be exported toexternal systems, a database, or other data storage structure. FIG. 8Aprovides an illustration of a graphical user interface which may be usedto create an examination form template with the types of cross-linkingand mappings discussed above. In this particular example, a dialog boxentitled “Report Demographics Layout” 380 may be displayed as shownafter the user has created the initial basic template. The user creatingthe template may select the scan button 381, which causes the templatecreation module to identify and list each of the template fields 382that has been added to the new template. Each of these template fieldsis shown inside brackets, indicating that it is not actual data, butrather is a data field.

The user may select one of the listed data fields 382. When a data field382 is selected, the Map External Field button 385 (shown as inactive inFIG. 8A) becomes active, and the user may select the button. Selectionof the Map Field button 385 activates an additional dialog box (notshown) that lists each of the data items that is available for importinto the examination form. These data elements may be accessed frominternal or external data structures. For example, the data elements maybe mapped from a PACS data structure or from an external data structure.The user may then select the desired choice for the mapping. Once theuser has selected a desired field for the mapping, the mapped field islisted in the same row as a corresponding external data source field 383for the selected data field 382. In the example shown in FIG. 8A, the[RefDoc] field 382 has been mapped to the “Ref Doc formatted name” dataitem 383 from the external data source. The user is also provided aClear external data source field button which allows for the deletion ofan association. In some embodiments, a single examination form field maybe mapped to more than one external data field. Moreover, a singleexamination form field may also be mapped to external data fields whichexist in multiple external data sources. Once the user is satisfied withtheir selected and assigned mappings, the user may test the mappings byselecting the header test button 387 which presents an example of theexamination form with appropriately mapped and inserted informationshown in the appropriate locations.

As noted above, in addition to mapping fields in the examination formtemplate for the purpose of importing data into the form, in someembodiments mappings may also be created in which sections or fields inthe examination form can be automatically mapped into one or moreexternal or internal reports, such as a reading physicians report forexample. Mapping data collected in an examination form to a physician'sreading report may be accomplished using reporting software which allowsfor the creation of report templates which import data from externaldata sources. Data contained in any particular examination form can bedirected to multiple different destinations. For example, some datamight go into a report describing the results of a radiology orcardiology exam. Some data from the same examination form might go intoa database stored in the radiology information system, a cardiovascularinformation system, PACS, a national databank, credentialingorganization, or any other local or remote storage device.

In one embodiment, a user can use a report template, and then one candesignate where one or more elements of the examination form willautomatically appear when a document (report) is opened that is based onthe report template that is linked to a particular examination form.

For example, a report template may be created using Microsoft Word®, anyother text editor, or a native CDA standard text editor. The reporttemplate may be linked to a particular exam type, so that when exams ofthat type are presented, the report template is used to automaticallygenerate a report document. The report template itself may independentlyimport data from one or more sources, including the examination formlinked to that exam type. For example the report template might includethe following mappings:

-   -   Exam Title: [mapped, for example, from an internal or external        data structure]    -   Date: [mapped, for example, from an internal or external data        structure][Exam form contents, indicating one or more specific        sections of examination form(s) that are mapped into the        report].

The brackets indicates positions in the report template whereinformation can be automatically inserted from one or more of eitherinternal data structures, external data structures, or where informationcan be inserted from a specified examination form linked to the sameexamination. The information inserted from the examination form mightinclude one or more lines of text, tables, diagrams, images, or otherinformation. It may include the entire examination form, specifiedsections of the examination form, or specified fields of the examinationform. An examination form that contains drop down menus, checklists,text areas, text fields, checkboxes, or radio buttons may be compiledduring this insertion process such that only those items that areselected or completed are imported into the report.

Whether or not information in a medical examination form is mapped to adestination may depend on the content entered into the form. Forexample, the information in a form may be processed using NaturalLanguage Processing to determine whether the content is mapped and thedestination or origination of that mapping. For example, if a specificcritical clinical or imaging finding is reported in an examination formdata field, the system may automatically generate a “critical results”report, or initiate an e-mail, automated phone call or other similarappropriate action to account for the situation.

Turning now to FIG. 8B, an example of how data is mapped from a dynamicmedical examination form to a report template is provided. As shown, theview 360 a of the dynamic medical examination form includes a text box361 a which allows a user (such as a technologist or patient, forexample) to enter comments about relevant medical examination. The view360 a also includes a family history field label 364 a and a familyhistory input field 365 a for input of the patient's family history.This data may already exist in a database or other structure within thePACS system. As a result, this data may be automatically retrieved andpopulated from the PACS database or other data source, as will bediscussed more fully below. The view 360 a also includes a menstrualhistory field label 366 a and a menstrual history input field 367 a.Additional field labels and fields are also provided such as thetechnique field label 368 a and its corresponding dropdown list 369 a;the uterus size field label 370 a and its corresponding dropdown list371 a; the ovaries field label and its corresponding radio buttons 373 aand 375 a.

In this example, view 360 a may have data fields that are cross-linkedwith a reading physicians report (that may be generated at any time inthe future) so that the information in Section 2, for example, may bedirectly mapped into the reading physician's report. In the exampleshown in FIG. 8B, the family history for the subject patient may alreadyby stored elsewhere in the system, such as in the PACS database, forexample. Thus, in addition to exporting data, it is to be appreciatedthat data may also be imported into the examination form from othersources. For example, in the medical examination form shown in FIG. 8B,the family history data 365 a may be imported from an external database,such as an EMR system 142.

Turning now to FIG. 8C, a view 360 b of the medical examination form isshown with the patient history data 365 b field having beenpre-populated using data retrieved from one or more external systems(and/or entered by a technician, patient, or other user). In oneembodiment, a user such as clerical personnel or a technologist withappropriate user rights may see the view 360 b. In the example shown,the family history is “Mother with history of ovarian cancer.” Theretrieved data is displayed as underlined text to show that it is newdata that has been added to the form. By providing a visual indicationthat the data was newly added, the user may be alerted that the veracityof the information may require confirmation. In some embodiments, when auser accesses this view (or any other view) for the first time, thepre-populated data will appear to the user (assuming, of course, thatthey have sufficient access permissions), and the user may then completepart or all of the remainder of the patient examination form using theuser interface elements provided. In the example shown in FIG. 8D, theremaining fields in the view 360 b have been completed by a user, asindicated by the underlined text. Once the examination form has beencompleted, the data entered in the examination form may be mapped toexternal systems as defined in the examination form template.

In many cases, views of medical examination forms may be completed by atechnologist or a clerical employee, and a report using various portionsof the data input in the views may be later reviewed by a readingphysician. In some embodiments, the medical examination form (orportions of the medical examination form) may be completed by a patient,e.g., at home, in advance of an exam via the web or by some other remoteuser. Advantageously, the medical examination forms disclosed hereinreceive information mapped from other sources and map information totargeted data destinations (such as medical reports, quality assurancedocuments) as part of their initial set up.

A reading physician may display a view of the examination form aftervarious other views of the form have been used to acquire data regardinga specific patient examination. The reading physician may edit theexamination form before or after its mapped contents have beentransferred to a report. In one embodiment, the physician may execute anaction to cause updated contents of the form to be transmitted to thereading physicians report.

The reading physician may further specify preferences which govern howthe examination form is displayed when accessed by the readingphysician. In some embodiments, the reading physician may specify thatthe view displayed to the reading physician includes all of the dataassociated with the examination form. As noted above, certain datafields in an examination form may be cross-linked with data fromexternal systems. For example, an MRI image for a patient may becross-linked to an examination form, but the image itself is notautomatically displayed in the form. Rather, a link to the image (suchas a hyperlink to the PACS server, for example) may be provided in theform. In some embodiments, the reading physician may specify apreference that the mapped fields of an examination form areautomatically displayed in any report generated from the examinationform. For example, the reading physician may specify that any linkedimages (such as MRI images, for example) be automatically displayed in areport based on the report template for the examination form.

FIG. 8E is an example of a graphical user interface of a reportgenerated by a report template based on the examination form 360 shownin FIGS. 8A-8D. As shown, the some of the data from the examination form360 has been transferred to the report. The report is typically intendedto present information and not to allow information to be modified. As aresult, only certain (or all) of the data associated with theexamination form (not the dropdown menus and multiple choice selections)are shown in the report. Moreover, that order of information may bedifferent than in the medical examination form, and it might not includeall information in the examination form. In addition, some reports maybe configured to include information from multiple examination forms toprovide additional relevant detail to the reader.

In some embodiments, more dynamic features of the dynamic medicalexamination forms may be utilized to provide better and more accuratedata capture that accounts for changes to a patient's condition overtime. In one particular embodiment, medical examination forms may bedynamically created based on a prior examination form (rather than basedon an examination form template as described above) so that informationfrom a prior examination may become organically part of the newcomposite examination form. By making information from the priorexamination form available on the new form, the ability to easilycompare old findings with new findings is provided. This ability can behelpful to efficiently compare changes in the size of lesions identifiedin CT, MRI or other scans, without requiring the reader to accessmultiple files to do so. In another particular embodiment, a medicalexamination form may be dynamically modified while it is being used. Forexample, new fields may be added to existing examination forms on thefly in order to document new anomalies (such as new lesions, forexample) that were not present in prior examinations, but would need tobe following during future examinations. In other embodiments, real-timebidirectional communication between an examination form and some othercomputer application may be provided to allow for recording correlationsof lesion measurements and positions within 2-dimensional images and3-dimensional imaging volumes.

FIG. 9 is an exemplary screenshot of a user interface which illustratesthe above-described dynamic embodiments. As shown, the figure includes ascreen window 805 which has two regions. The first region 810 (the top ¾of the drawing) is related to a PACS workstation application, and thesecond region 840 (the bottom ¼ of the drawing) is related to a view ofa patient examination form that has been pre-populated with informationfrom a previous MRI scan of Jun. 12, 2008. The patient data shown inthis example is the type of data that may be used by a radiologist tointerpret a brain MRI scans in a patient with multiple metastatic brainlesions. However, other types of examinations could also be carried outusing the dual region interface 805. For example, in anotherimplementation, an ultrasound technologist may use the interface 805 todocument thyroid nodules in a thyroid ultrasound.

In the example provided in FIG. 9, the first region 810 is part of aPACS workstation graphical user interface. The PACS workstation userinterface is typically used to interpret medical imaging examinations.As shown, the left column of the first region 810 displays two images822 and 824 from a patient's prior examination (dated Jun. 12, 2008 inthis example) as shown by label 820. The right column of the firstregion 810 includes two images from follow-up examination (dated Sep.14, 2008), as shown by label 830.

The second region 840 includes a view of a dynamic examination formhaving a scroll bar 836 that allows the user to scroll to undisplayedportions. Although the first region 810 and the second region 840 areshown on the same user interface display in this example, it is to beappreciated that the first region and second region can be displayed onseparate displays. The second region 840 includes a view of anexamination form that was created on Jun. 12, 2008, as shown by label812. Certain fields used in the prior examination (which took place onJun. 12, 2008) are replicated on the right side of the second region 840in order to allow the fields from the old report to be used to allowefficient comparison between the Jun. 12, 2008 examination and the Sep.14, 2008 examination. In this example, the user would fill in thesefields on the right (854, 860, and 862) based on the findings of thecorresponding exam on that date.

The right side of the second region 840 of the user interface 805provides an interface by which a user can enter findings interpretingthe images from the first region. Each of the right side and left sideof the second region 840 includes data fields for data relating to thecorresponding imaging in the first region 810. For example, the“Ventricles” field label 842 is associated with the “Ventricles” fieldvalue. For the earlier exam, the Ventricles field value is set to“Normal,” while the new examination includes an active dropdown list 844which allows the user to set the value for the new examination findings.The second region 840 also includes a text label 850 which provides aheading for fields that are listed below.

The fields listed below the text label 850 are related to a series ofmetastatic lesions identified in the previous medical examination datedJun. 12, 2008. For example, field label 851 refers to a lesion observedon the “Right Medial Temporal” lobe of the patient. The associated fieldvalue 852 lists the size of the lesion as observed in the Juneexamination, “0.2” cm. A corresponding field 854 has been created in thenew medical examination form on the right side of the second region 840.In this instance, the user has entered a new value “1.2” cm to reflect athe size of the metastatic lesion on the follow-up exam dated Sep. 14,2008. This value could be typed in by the user or entered by othermeans.

In one embodiment, real-time bidirectional communication between thePACS workstation application and the examination form allows formeasurements made in the PACS software to be linked to the examinationform and entered automatically. In the example shown in FIG. 9,measurements made by the user on the images in region 810 may beimmediately translated into values which appear in the measurementfields 854, 860, and 862 in the examination form provided in region 840.For example, the user may click on a measurement field such asmeasurement field 854, causing the field to become the active field (asindicated by the inverted black/white appearance). The user may thenmake a measurement of a lesion using the PACS workstation software. Inthis example, the measurement is performed on the image 832 as indicatedby the positioning of two mouse cursors around a lesion near the centerof the scan image. The measurement provided by the PACS workstationsoftware is dynamically entered into the active field 854. In oneembodiment, this dynamic behavior is provided by a mapping included inthe base template for the examination form.

The user interface 805 shown in FIG. 9 also allows the examination formsto be dynamically enhanced to add fields for newly located lesions. Inthe example provided, an “Add New Lesion” button 838 is provided whichallows a user to dynamically create a new lesion field which wouldspecify a location and a measurement. The newly added lesion may beavailable for subsequent examinations if the new examination form isbased on the prior examination form in the same manner as shown in FIG.9. In additional embodiments, additional user interface elements may beadded to account and record additional examination findings that may betracked in future examinations.

In an additional embodiment, the position where the measurement wastaken would be recorded in, for example, in a non-visible portion of theexamination form, a database or file. By recording the position of themeasurement, the entry in the examination form may be linked to2-dimensional or 3-dimensional positions in images or image volumes.

In still another embodiment, the bi-directional communication betweenthe examination form software 151 and the external PACS system softwaremay further provide the ability to link examination form fields (such asfields 850) with regions and structures in the images. The linking maybe implemented in both directions such that when a user clicks on anexamination form field, the corresponding image and specific location inthe image may be displayed in the first region 810 of the display 805.Similarly, linking may be implemented from the image to the examinationform. In this aspect, when the user moves the mouse cursor over an imagedisplayed in the first region 810, a field associated with the portionof the image under the cursor becomes activated. As illustrated in FIG.9, the user has positioned the cursor over a portion of image 822 wherea measurement has been made and a window labeled “Right Medial Temporal”is automatically displayed, the field name of the measurement made atthat position.

FIGS. 10A-10G illustrate additional embodiments in which a graphicaluser interface environment is provided to allow for medical examinationforms to be set up and create, copy, save, modify, and designexamination forms. In the examples shown in FIGS. 10A-10G, the dynamicmedical examination forms described are referred to as “ExamForms,” andit is to be appreciated that these are merely additional embodiments ofthe dynamic medical examination forms discussed above.

Referring now to FIG. 10A, a user interface 1000 is provided whichincludes a row of tabs 1002 that may be selected by the user. In someembodiments, the tabs 1002 displayed in the user interface 1002 may bedependent on the identity and/or role of the user. For example, aclerical employee may not have permission to see certain functionalityand forms included in the system, in which case, certain tabs may behidden from that user. A medical doctor, on the other hand, may haveextensive permissions within the system, and may therefore be shownadditional tabs not presented to other users. As shown the ExamFormTemplate tab 1004 has been selected by the user, which causes the systemto display a list of examination form templates 1006 from which aselection can be made. When the user makes a selection of an examinationform template, the user may be taken through a series of templatecreation screens from which an examination form may be created andlinked to specific medical examination types as will be discussed below.

Turning to FIG. 10B, an example of an examination form template editor1008 which may be presented to a user upon selection of an examinationform template from the list 1006 shown in FIG. 10A. The examination formtemplate editor 1008 may include an information window 1010 and anediting window 1012. The information window 1010 may include informationthat provides instructions to the user in order to assist their designof the examination form. In the example shown in FIG. 10B, theinformation window 1010 includes step-by-step instructions which providedetailed information to the user for setting up the examination form.The editing window 1012 is used to provide an interface from which theactual design elements of an examination form may be presented andmanipulated. In this particular example, multiple sections have beendefined which can be associated with different examination formproperties and functions. Sections may also be defined based on theidentity or role of the user that will complete that specific portion ofthe examination form. For example, “Section 1” 1014 may be designed sothat its contents will be presented to technologists only. The firstsection 1014 may include various information and fields that may be usedby a technologist in an associated patient examination. The firstsection 1014 may include Technologist Note text area 1018. TheTechnologist Note area 1018 provides a text area in which a technologistmay enter notes regarding their role in a patient examination. The notesentered in this area may be visible to the technologist and to otherusers having sufficient permissions to access this portion of anexamination form created from this template.

In some embodiments, the different sections may also be defined based onwhether the information entered into that section of the form will bemapped into an external data entity. For example, in the template shownin FIG. 10B, the first section 1014 may be configured so that none ofthe information in that section is mapped into the reading physician'sreport associated with that examination form. In contrast, theinformation entered into the second section 1016 in an examination formcreated from the examination form template may be automatically mappeddirectly into a reading physicians report. For example, the data enteredinto the exam data fields 1022 may be automatically imported into aprecisely mapped location in a physician's report defined for use withthis examination form.

As discussed above in connection with FIG. 8A, external data fields maybe mapped into an examination form. In the examination template editorinterface 1010 shown in FIG. 10B, a number of different patientinformation fields 1020 are mapped into the examination form. As shown,the patient information fields are indicated by brackets. Mappings toexternal data may be created using a dialogue box such as that shown inthe information window 1010. The information window 1010 provide theuser with information on how database fields (indicated by bracketedareas near the top of the ExamForm—arrow) can be created, located,detected and mapped, so that information from an external database (inthis example a DR Systems database) or some another datasource can beautomatically imported when an ExamForm is created based on thisExamForm template.

In some embodiments, examination form templates may be linked to one ormore specific examination types. When an examination form template islinked to a specific examination type, the appropriate examination formtemplate may be presented to a user when the user wishes to create a newexamination form. FIG. 10C is an example of how an examination formtemplate can be linked to one or more specific exam types. Linking anExamForm template to an exam type is just one of many possible linksthat can govern which template should be used to create a particularexamination form. In the example shown, a user has selected anexamination form template 1030 entitled “U S CARDIAC CART WITH NO”. Inresponse to that selection, an linking window 1031 is displayed to theuser. The linking window 1031 indicates the template with which it isassociated by listing a examination template identifier 1032 and anexamination template name 1034. A list of medical examinations 1036 froma pool of available examination is presented to the user, from which oneor more examinations may be selected for association with the currentexamination form template. After one or more medical examinations fromthe list 1036 have been selected, the user may create the link betweenthe examination type and the examination template by selecting the “Add”button 1038. A visual indication of the link is provided by moving theselected examination types from the list 1036 to the linked examinationlist 1037 below. Links to specific examination types may be removed byselecting the specific examination type and pressing the “Remove” button1040. Once the user has completed linking the examination types, thewindow may be closed by selecting the “Exit” button 1042.

As noted above in connection with FIG. 10B, an examination form may bedesigned such that specific sections of fields may be mapped to othertemplates, such as reporting templates, for example. FIG. 10D an exampleof a physician's report template which may be configured toautomatically receive data from a corresponding examination form andgenerate a reading physician's report using data received from, interalia, an examination form. As shown, a reporting template file name 1050has been selected by a user. The reporting template may include amapping 1048 from an examination form which is automatically importedwhen a physician's report is created based on this report template. Themapping may be created by utilizing the Map to Other Report Dialog box1054 shown in the figure.

Based on the design of the examination form, some or all of theexamination form may be mapped to the physician's report. Furthermore,although this user interface illustrates only one mapping location 1048for the examination form into the physician's report, various differentparts or fields from the examination form may be mapped into differentsections of the physicians report. In addition, certain embodiments mayprovide multiple report templates (and subsequent reports) for the sameexamination or patient, each with different examination form mappings.

As discussed above in connection with FIG. 8, once an examination formtemplate has been defined, an examination form may be created which isbased on the template. FIG. 10E is an example of a view of theexamination form that was created from an examination form template. Inthis particular embodiment, a plurality of data fields 1060 have beenautomatically imported into the view of the examination form. These datafields 1060 include the patient name, the examination type, the data ofbirth for the patient, and the date of the examination. The informationin the examination report shown in FIG. 10E may be presented to a userto fill assist in completing a patient examination. In this particularexample, the first section 1062 includes information about the patientexamination which may be presented to a user of the examination form.The user may be a technologist who has been assigned to provide furtherinformation into the examination form. The technologist can recordcomments in the Technologist Note text area 1064 that will be associatedwith the examination form, but not transmitted to other repositories orphysicians' reports in this embodiment.

The second section 1066 of the examination form may provide additionaldropdown menus or text fields as shown. Although not shown in thisexample, many other user interface elements, such as radiobuttons,checkboxes, required fields, etc. can be employed in the examinationform design. As noted above, certain data entered into the examinationform may be exported to a physicians report. In one embodiment, data isonly exported if information is provided by the user. Thus, if noinformation is placed in the text area next to the Dose-Length Product1068, when the contents of Section 2 are imported into a physician'sreading report, the entire text area will be omitted. In this way, thephysician's reading report will not have the appearance of a form, eventhough it was created, in part, from a form.

Turning now to FIG. 10F, an example of an examination form is providedin which an Auto-Import Note (Section 2) is provided for receiving datafrom a technologist. In this example, the data may be entered into theexamination form while a physician is performing a procedure. Thus, theassistant/technologist can be completing information in the examinationform in real-time during the examination procedure. The informationentered into the examination form may then be automatically exportedinto a physicians report, so that the physician need only edit and/orapprove the report. As discussed above, some portions of the examinationform may be automatically completed when the form is generated. In thisexample, the information (LEFT HEART CATH, SERVICE CODE 93510) has beenautomatically imported from a data source. As the procedure iscompleted, the examination form may be updated to import supplies thatwere used during procedure.

After a technologist has finished using the examination form, aphysician's report may be automatically generated to include dataexported from the examination form as previously discussed. FIG. 10G isan example of a user interface that a physician may use to evaluate aphysician's report. In this example, a completed examination form 1080is displayed on the left, and the generated physician's report 1090 isdisplayed on the right. The reading physician may define preferencessuch that both the examination form 1080 and reading report 1090 aresimultaneously displayed. In some embodiments, the physician may beprovided extensive control over the timing and location of displayeddata. For example, a physician may prefer not to have an examinationform displayed at all, but may set his preferences to simply see thephysician's report on the right with the examination form mapped dataalready imported.

In this example, the physician's report 1090 contains information 1092that did not come from the examination form, but instead came from otherdata mapping. Depending on the specific implementation, the physicianmay have the right to edit the physician's report 1090 directly, or mayedit the examination form 1080 and then resend the data to thephysician's report. In addition, a physician might make variousmeasurements or annotations of associated medical images, with such datatransferred automatically to the examination form, the physician'sreport, both, neither, or other data stores.

Although the specific embodiments set forth above relate to medicalexamination forms, a skilled artisan will appreciate that the systemsand methods disclosed herein may be utilized outside of the medicalexamination context. For example, the systems and methods could beapplied in the context of automotive diagnosis and repair. Otherimplementation environments are envisioned.

Those of skill will recognize that the various illustrative logicalblocks, modules, circuits, and algorithm steps described in connectionwith the embodiments disclosed herein may be implemented as electronichardware computer software or combinations of both. To clearlyillustrate this interchangeability of hardware and software, variousillustrative components, blocks modules, circuits, and steps have beendescribed above generally in terms of their functionality. Whether suchfunctionality is implemented as hardware or software depends upon theparticular application and design constraints imposed on the overallsystem.

Skilled artisans may implement the described functionality in varyingways for each particular application, but such implementation decisionsshould not be interpreted as causing a departure from the scope of thepresent invention. The various illustrative logical blocks, modules, andcircuits described in connection with the embodiments disclosed hereinmay be implemented or performed with a general purpose processor, adigital signal processor (DSP), an application specific integratedcircuit (ASIC), a field programmable gate array (FPGA) or otherprogrammable logic device, discrete gate or transistor logic, discretehardware components, or any combination thereof designed to perform thefunctions described herein.

A general purpose processor may be a microprocessor, but in thealternative, the processor may be any conventional processor,controller, microcontroller, or state machine. A processor may also beimplemented as a combination of computing devices, e.g., a combinationof a DSP and a microprocessor, a plurality of microprocessors, one ormore microprocessors in conjunction with a DSP core, or any other suchconfiguration.

The steps of a method or algorithm described in connection with theembodiments disclosed herein may be embodied directly in hardware, in asoftware module executed by a processor, or in a combination of the two.A software module may reside in RAM memory, flash memory, ROM memory,EPROM memory, EEPROM memory, registers, hard disk, a removable disk, aCDROM, or any other form of storage medium known in the art. Anexemplary storage medium is coupled to the processor such the processorcan read information from and write information to, the storage medium.In the alternative, the storage medium may be integral to the processor.The processor and the storage medium may reside in an ASIC. The ASIC mayreside in a user terminal. In the alternative the processor and thestorage medium may reside as discrete components in a user terminal.

What is claimed is:
 1. A computing system comprising: a computerreadable storage medium having program instructions embodied therewith;and one or more processors configured to execute the programinstructions to cause the one or more processors to: access a datastructure storing an examination form template, wherein the examinationform template includes: indications of one or more information fields,for at least some of the one or more information fields, indications ofrespective import links to respective data sources that provideinformation to be automatically imported into respective informationfields from the respective data sources, and for at least some of theone or more information fields, indications of respective locationswithin a medical report associated with the examination form templatewhere information input into the respective information field is to beincluded in the medical report; automatically retrieve, based on theindications of the import links of the examination form template, one ormore items of information from respective data sources for automaticimportation into respective of the at least some of the one or moreinformation fields of the examination form template; instantiate anexamination form based on the examination form template, the examinationform including the one or more information fields of the examinationform template and the one or more items of information imported into therespective of the at least some of the one or more information fields ofthe examination form template; in response to a request to view theexamination form by a first user: determine a first role associated withthe first user; generate a first interactive view of the examinationform for display to the first user based on the first role associatedwith the first user, wherein the first interactive view is configured toreceive data in a first subset of the one or more information fields ofthe examination form; receive data input into at least some of the firstsubset of the one or more information fields of the first interactiveview of the examination form; and dynamically store the data input intothe at least some of the first subset of the one or more informationfields in association with the respective information fields of theexamination form; generate a medical report based on a portion of thedata input into the examination form by the first user, wherein:information associated with at least some of the one or more informationfields of the examination form is included in the medical report inrespective locations as indicated by the examination form template ofthe examination form, and at least some of the information of theexamination form is not included in the medical report.
 2. The computingsystem of claim 1, wherein the examination form is associated with acurrent examination of a patient, and wherein the one or more processorsare configured to execute the program instructions to further cause theone or more processors to: determine that a previous examination formassociated with a previous examination of the patient has previouslybeen generated and includes previous medical information specific to thepatient; and automatically store at least some of the previous medicalinformation in association with associated information fields of theexamination form.
 3. The computing system of claim 2, wherein the one ormore processors are configured to execute the program instructions tofurther cause the one or more processors to: generate a user interfacefor display to at least one of the first user or the second user, theuser interface including a first one or more medical images from theprevious examination of the patient and a second one or more medicalimages from the current examination of the patient.
 4. The computingsystem of claim 3, wherein the previous medical information includes ameasurement of a particular feature depicted in the first one or moremedical images and the user interface includes one or more controlsconfigured to allow the at least one of the first user or the seconduser to provide an updated measurement of the particular featuredepicted in the second one or more medical images.
 5. The computingsystem of claim 4, wherein a location of the measurement of theparticular feature depicted in the first one or more medical images isstored in the previous examination form.
 6. The computing system ofclaim 5, wherein the one or more processors are configured to executethe program instructions to further cause the one or more processors to:determine an expected location of the particular feature in the secondone or more medical images based at least on the stored location of themeasurement of the particular feature.
 7. The computing system of claim3, wherein the one or more processors are configured to execute theprogram instructions to further cause the one or more processors to:enable communication between a first software application used todisplay the first one or more medical images and a second softwareapplication used to display the examination form, wherein the firstsoftware application is configured to enable the at least one of thefirst user or the second user to measure features depicted in the firstone or more medical images and/or the second one or more medical images,and the communication between the first software application and thesecond software application comprises communication of measurements madein the first software application for display in the examination form.8. The computing system of claim 7, wherein the communication betweenthe first software application and the second software applicationfurther comprises: receiving a selection of a first information field inthe examination form generated by the second software application;receiving a measurement on the first one or more medical imagesdisplayed by the first software application; and automaticallypopulating the first information field in the examination form with themeasurement.
 9. The computing system of claim 3, wherein the one or moreprocessors are configured to execute the program instructions to furthercause the one or more processors to: access, from the data structure,information associating regions of the second one or more medical imageswith corresponding information fields of the examination form; and inresponse to selection of a particular region of the second one or moremedical images, automatically select a particular information field inthe examination form that corresponds to the particular region.
 10. Thecomputing system of claim 9, wherein the one or more processors areconfigured to execute the program instructions to further cause the oneor more processors to: in response to automatic selection of theparticular information field, automatically populate the particularinformation field of the examination form with a subsequent measurementon the second one or more medical images.
 11. The computing system ofclaim 3, wherein the one or more processors are configured to executethe program instructions to further cause the one or more processors to:access, from the data structure, information associating regions of thesecond one or more medical images with corresponding information fieldsof the examination form; and in response to selection of a particularfield of the examination form, select a particular region of the secondone or more medical images.
 12. The computing system of claim 1, whereinthe examination form includes one or more user interface controlsconfigured to allow the user to add new information fields to theexamination form.
 13. The computing system of claim 1, wherein the oneor more processors are configured to execute the program instructions tofurther cause the one or more processors to: automatically import theone or more items of information into the respective of the at leastsome of the one or more information fields of the examination formtemplate.
 14. The computing system of claim 1, wherein the one or moreprocessors are configured to execute the program instructions to furthercause the one or more processors to: export respective portions ofinformation of the examination form to a plurality of respective datadestinations as indicated by one or more export rules of the examinationform template, wherein: not all of the information of the examinationform is exported to all of the data destinations as indicated by theexport rules such that bandwidth needs are reduced and efficiency ofcategorizing portions of information of the examination form received atat least some of the data destinations is increased, at least one of theplurality of respective data destinations is a medical report, and atleast one other of the plurality of respective data destinations is atleast one of a billing system, a backup database, a clinical informationsystem, or a data repository.
 15. A computer-implemented methodcomprising: by one or more processors executing program instructions:accessing a data structure storing an examination form template, whereinthe examination form template includes: indications of one or moreinformation fields, for at least some of the one or more informationfields, indications of respective import links to respective datasources that provide information to be automatically imported intorespective information fields from the respective data sources, and forat least some of the one or more information fields, indications ofrespective locations within a medical report associated with theexamination form template where information input into the respectiveinformation field is to be included in the medical report; automaticallyretrieving, based on the indications of the import links of theexamination form template, one or more items of information fromrespective data sources for automatic importation into respective of theat least some of the one or more information fields of the examinationform template; instantiating an examination form based on theexamination form template, the examination form including the one ormore information fields of the examination form template and the one ormore items of information imported into the respective of the at leastsome of the one or more information fields of the examination formtemplate; in response to a request to view the examination form by afirst user: determining a first role associated with the first user;generating a first interactive view of the examination form for displayto the first user based on the first role associated with the firstuser, wherein the first interactive view is configured to receive datain a first subset of the one or more information fields of theexamination form; receiving data input into at least some of the firstsubset of the one or more information fields of the first interactiveview of the examination form; and dynamically storing the data inputinto the at least some of the first subset of the one or moreinformation fields in association with the respective information fieldsof the examination form; generating a medical report based on a portionof the data input into the examination form by the first user, wherein:information associated with at least some of the one or more informationfields of the examination form is included in the medical report inrespective locations as indicated by the examination form template ofthe examination form, and at least some of the information of theexamination form is not included in the medical report.
 16. Anon-transitory computer readable medium storing computer-executableinstructions that, when executed by one or more computer processors of acomputing system, cause the one or more computer processors to: access adata structure storing an examination form template, wherein theexamination form template includes: indications of one or moreinformation fields, for at least some of the one or more informationfields, indications of respective import links to respective datasources that provide information to be automatically imported intorespective information fields from the respective data sources, and forat least some of the one or more information fields, indications ofrespective locations within a medical report associated with theexamination form template where information input into the respectiveinformation field is to be included in the medical report; automaticallyretrieve, based on the indications of the import links of theexamination form template, one or more items of information fromrespective data sources for automatic importation into respective of theat least some of the one or more information fields of the examinationform template; instantiate an examination form based on the examinationform template, the examination form including the one or moreinformation fields of the examination form template and the one or moreitems of information imported into the respective of the at least someof the one or more information fields of the examination form template;in response to a request to view the examination form by a first user:determine a first role associated with the first user; generate a firstinteractive view of the examination form for display to the first userbased on the first role associated with the first user, wherein thefirst interactive view is configured to receive data in a first subsetof the one or more information fields of the examination form; receivedata input into at least some of the first subset of the one or moreinformation fields of the first interactive view of the examinationform; and dynamically store the data input into the at least some of thefirst subset of the one or more information fields in association withthe respective information fields of the examination form; generate amedical report based on a portion of the data input into the examinationform by the first user, wherein: information associated with at leastsome of the one or more information fields of the examination form isincluded in the medical report in respective locations as indicated bythe examination form template of the examination form, and at least someof the information of the examination form is not included in themedical report.